腔内隔绝术治疗胸主动脉夹层动脉瘤

目的：探讨腔内隔绝术治疗胸主动脉夹层动脉夹层动脉瘤的手术指征、术前评估方法、技术操作要点、存在问题及临床应用前景。方法：１９９８年９月至１９９９年５月对１０例慢性ＳtanfordＢ型胸主动脉夹层动脉瘤患者施行了腔内隔绝术，移植物为Ｚ型记忆合金支架与涤纶人工血管复合体，移植物口径根据螺旋ＣＴ动脉造影测量决定，手术在ＤＳＡ动态监视下完成 。结果：手术后早期死亡１例，死于内漏所致的动脉瘤破裂。其余９例手术操作

Endovascular graft exclusion for thoracic aortic dissections

Objective: To assess the operation indications, preoperative evaluation, technique essentials and clinical prospective of endovascular graft exclusion (EVGE) in treatment of thoracic aortic dissection (TAD). Methods: Since September 1998, EVGE for TAD have been performed on 10 patients. Graft was constructed from self expanding Z stents covered with a woven Dacron polyester fabric graft. Graft dimensions were determined by spiral computerized tomographic scans. All operations were performed under DSA guidance. Results: There was one early death due to endoleaks. Procedures in the other 9 patients were successful. No complications such as myocardial infarction, lung failure, kidney failure and paralysis that commonly occurr after conventional operations were observed. Immediate thrombosis in false lumen was achieved in 6 patients, and late thrombosis occurred in 3 patients. Mean follow up duration was 3 months, the aneurysmal diameter decreased obviously. Conclusion: These early results support the hypothesis that EVGE may be a safe and effective treatment for selected patients with TAD. Endoleak may lead to continued aneurysmal expansion and rupture.